| NPI | 1487117628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1315756) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |